BMC Cardiovascular Disorders最新文献

{"title":"Triglyceride-glucose index and abnormal blood pressure in adults aged over 70 years: real-world data evidence.","authors":"Yongcheng Ren, Dongdong Qi, Hang Yin, Yuxuan Han, Jing Zhang, Hao Chen, Lei Yang","doi":"10.1186/s12872-026-05938-y","DOIUrl":"https://doi.org/10.1186/s12872-026-05938-y","url":null,"abstract":"<p><strong>Background: </strong>Existing studies on the association between the triglyceride-glucose index (TyG) and hypertension often rely on simplified hypertension classifications and provide limited evidence specific to the elderly population (aged ≥ 70 years). This study aims to explore the relationship between the TyG index and different subtypes of abnormal blood pressure in older adults.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 2022 using random cluster sampling, including 12,690 permanent residents aged ≥ 70 years from rural communities. Blood pressure was measured by uniformly trained staff using calibrated electronic sphygmomanometers under resting conditions. The triglyceride-glucose (TyG) index was analyzed both as a continuous variable and in quartiles. Multivariable logistic regression models, adjusted for age, sex, education level, marriage, smoking, alcohol consumption, family history of diabetes, family history of hypertension, heart rate, and body mass index, were used to assess the associations between the TyG index and hypertension subtypes. The discriminatory ability of the TyG index was evaluated using receiver operating characteristic (ROC) curve analysis, with adjustment for the same set of covariates.</p><p><strong>Results: </strong>The overall crude prevalence of hypertension (HTN) was 55.9%. The prevalence rates of systolic hypertension (SHTN), grade 1 hypertension (HTN-I), and grade 2 hypertension (HTN-II) were 37.6%, 37.5%, and 18.3%, respectively. Participants in the highest TyG index quartile had a significantly increased risk of all hypertension subtypes compared to those in the lowest quartile. Trend analysis showed that each 1-unit increase in the TyG index was associated with increased risks of HTN (OR = 1.39, 95% CI: 1.18-1.63), SHTN (OR = 1.33, 95% CI: 1.11-1.60), HTN-I (OR = 1.30, 95% CI: 1.09-1.55), and HTN-II (OR = 1.52, 95% CI: 1.22-1.89) (P for trend < 0.01). ROC curve analysis determined optimal TyG cutoff values for predicting HTN (8.96), SHTN (8.96), HTN-I (8.96), and HTN-II (9.11), but modest discriminatory ability of the TyG index for these abnormal blood pressure subtypes (all P < 0.001), with areas under the curves (AUCs) ranging from 0.56 to 0.58.</p><p><strong>Conclusion: </strong>An elevated TyG index is independently associated with abnormal blood pressure in the elderly, with a particularly strong association observed for HTN-II. Although its discriminatory power as a standalone diagnostic tool is limited, the index may serve as a useful auxiliary factor for hypertension risk assessment in this population.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coffee, caffeine, and cardiovascular health: navigating risks and benefits-an updated systematic review and meta-analysis.","authors":"Eman E Shaban, Hussam Elmelliti, Ahmed Shaban, Amira Shaban, Ali Elkandow, Mohamed Gafar Abdelrahim, Hany A Zaki","doi":"10.1186/s12872-026-05693-0","DOIUrl":"https://doi.org/10.1186/s12872-026-05693-0","url":null,"abstract":"<p><strong>Background: </strong>The association between coffee or caffeine intake and cardiovascular diseases (CVDs) and their risk factors has been extensively researched. However, there has been conflicting evidence. Therefore, the current updated meta-analysis assessed the relationship between coffee or caffeine with CVDs, such as coronary heart diseases (CHDs), myocardial infarction (MI), heart failure (HF), stroke, cardiac arrhythmias, and CVD mortality.</p><p><strong>Methods: </strong>Five electronic databases, namely PubMed, Web of Science, Cochrane Library, Embase, and Scopus, were extensively searched for all records published between January 2000 and December 2025. Studies were included if they examined the effects of coffee on any CVD and reported the associations in terms of the hazard ratio (HR), relative risk (RR), or odds ratio (OR). Moreover, quality appraisal was conducted using the Newcastle Ottawa Scale for cohort studies and the Joanna Briggs Institute tool for case-control studies.</p><p><strong>Results: </strong>After exclusions, 38 studies involving 2,856,002 participants were reviewed and analyzed. The pooled analysis showed no significant associations between coffee consumption and total CHDs or HF, when comparing the highest and lowest coffee consumption categories (HR: 0.98; p = 0.80 and HR: 1.03; p = 0.62, respectively). In contrast, the pooled results showed a significant positive association between higher coffee consumption and the risk of developing MI (OR: 1.48; p < 0.0001). The pooled analysis also showed an inverse relationship between coffee consumption and stroke or cardiac arrhythmias (HR: 0.89; p = 0.01 and HR: 0.94; p = 0.04, respectively). Furthermore, we observed a non-linear relationship between caffeine intake and CVD mortality among hypertensive patients (HR: 0.68; p = 0.001).</p><p><strong>Conclusion: </strong>Higher coffee intake might increase the risk of MI, but can also offer protective effects against stroke and cardiac arrhythmias. Moreover, higher caffeine intake can reduce the risk of CVD mortality in hypertensive patients.</p><p><strong>Clinical trial registration: </strong>PROSPERO: CRD420251073620.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of perioperative amiodarone for prevention of postoperative atrial fibrillation (POAF) in cardiac surgery patients: update and reevaluation of timing, route, and dosage.","authors":"Zemeng Li, Shilin Wang, Lili An, Chen Chen, Guitao Zhang, Liang Chen, Juan Du","doi":"10.1186/s12872-026-05813-w","DOIUrl":"https://doi.org/10.1186/s12872-026-05813-w","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, and perioperative amiodarone is recommended for POAF prophylaxis, while the optimal timing, route, and dosage remain unclear. The purpose of this study is to evaluate the efficacy of perioperative amiodarone for the prevention of POAF in patients undergoing cardiac surgery and to reevaluate the impact of its timing, route, and dosage.</p><p><strong>Methods: </strong>Data were collected through searching PubMed, Embase, and the Cochrane Library from inception until September 30, 2025, for randomized controlled trials (RCTs). Data were pooled using a random-effects model.</p><p><strong>Results: </strong>Forty RCTs involving 6,166 patients were included. Amiodarone was associated with a substantial reduction in the incidence of POAF (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.31 to 0.49, P < 0.00001, I² = 57%). The preventive efficacy may be primarily influenced by the combination of administration timing and route, rather than by the cumulative dose alone. Notably, a significant dose-response relationship was observed within the preoperative through postoperative oral strategy. Statistically significant differences were found in length of hospital stay (mean difference -1.33 days, P < 0.0001) and cerebrovascular accident (OR = 0.59, P = 0.04), and an increased risk of bradycardia (OR = 2.33, P < 0.00001). No statistically significant differences were found in mortality, heart block, or hypotension.</p><p><strong>Conclusions: </strong>Prophylactic perioperative amiodarone may be associated with a reduced incidence of POAF, consistent with current guideline recommendations, and the timing and route of administration appear to play a more important role than the dose alone. While an increased risk of bradycardia was observed, no clear association with major adverse outcomes was identified. These results should be interpreted cautiously and may help optimize prophylactic strategies in appropriate clinical contexts.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between lifestyle and initiation of cardiovascular preventive medicines in 60-year-olds at low to moderate cardiovascular risk level - a prospective cohort study based on the VIPVIZA-trial.","authors":"Tove Lindström Lundgren, Eva-Lotta Glader, Henrik Holmberg, Margareta Norberg, Anders Själander, Eva Sönnerstam","doi":"10.1186/s12872-026-05922-6","DOIUrl":"https://doi.org/10.1186/s12872-026-05922-6","url":null,"abstract":"<p><strong>Background: </strong>Medicines complement healthy lifestyles in cardiovascular disease (CVD) prevention, but knowledge is lacking on how behaviours in these domains are related. This study aimed at investigating associations between physical activity and diet, and time to initiation of preventive medicines.</p><p><strong>Method: </strong>A cohort study based on the \"Visualization of Asymptomatic Atherosclerotic Disease for Optimal Cardiovascular Prevention\" (VIPVIZA)-trial, including 60-year-olds of low/moderate CVD-risk who were treatment-naive to antihypertensives or lipid-lowering medicines six months prior trial-inclusion. Sex-specific Cox proportional hazards models were used to analyse impacts of diet and physical activity, each categorized in three levels (least healthy - moderately healthy - healthiest), on initiation of antihypertensives and lipid-lowering medicines.</p><p><strong>Results: </strong>Of 1891 individuals in the cohort, 1340 (58% women) were antihypertensive-naive and 1783 (57% women) were lipid-lowering naive. Significantly faster initiation of antihypertensives was seen in women with the healthiest diet (HR [95%CI] 2.46 [1.18-5.14], ref. least healthy) whereas higher levels of physical activity were significantly associated with slower initiation of antihypertensives in women (HR [95%CI], moderate; 0.51 [0.30-0.88]), high; 0.48 [0.30-0.77], ref. low). Neither diet nor physical activity levels affected initiation of lipid-lowering medicines in women, and lifestyle factors were not associated with initiation of antihypertensives or lipid-lowering medicines in men.</p><p><strong>Conclusions: </strong>Relationships between lifestyle and medicine initiation varies with health behavior, drug-class, and sex. Regarding diet, initiation of antihypertensives in women may agree with a healthy adherer effect, whereas for physical activity, the association appear inverse. Diet and physical activity levels are less influential for initiation in men, and for lipid-lowering medicines. As findings are uncertain, further studies are needed to clarify relationships between these factors.</p><p><strong>Trial registration: </strong>VIPVIZA-trial registration number: NCT01849575, registration date: 2013-05-08.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute type A aortic dissection: assessment of surgically treated and autopsied cases.","authors":"Mesut Yilmaz, Bengü Berrak Ozkul, Nevzat Erdil, Osman Celbis","doi":"10.1186/s12872-026-05951-1","DOIUrl":"https://doi.org/10.1186/s12872-026-05951-1","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (TAAD) is the most frequently encountered pathological condition of the aorta and constitutes one of the most fatal cardiovascular emergencies. This study aimed to determine the risk factors in aortic dissection and aortic dissection-related mortality by examining the characteristics of surgically treated TAAD cases and autopsied TAAD cases.</p><p><strong>Methods: </strong>A total of 157 cases from two centers were included in the study between 2003 and 2022: 141 cases of acute TAAD who underwent surgical treatment at the Department of Cardiovascular Surgery, and 16 autopsied cases identified at the Forensic Medicine Morgue Department. Medical records of the surgically treated patients at the Department of Cardiovascular Surgery and autopsy reports from the Forensic Medicine Morgue Department were reviewed, and the findings from both centers were evaluated.</p><p><strong>Results: </strong>Of all cases included in the study, 72.6% were male and 46.9% were between 46 and 64 years of age. The mortality rate among surgically treated cases was 17%. The mortality rate was 30.6% in surgically treated cases with preoperative malperfusion and 9.8% in those without malperfusion. Hypertension was the most prevalent comorbidity, being present in 93.6% of the cases. Multivariable logistic regression analysis showed that the presence of preoperative malperfusion increased the risk of mortality by approximately 2.9-fold, while age was not identified as an independent risk factor in the model.</p><p><strong>Conclusion: </strong>Malperfusion was identified as the factor most strongly associated with mortality in surgically treated cases, and its independent association with an approximately 2.9-fold increase in mortality supports its role as one of the major determinants of prognosis. The high prevalence of atheromatous plaques in the aorta and coronary arteries in autopsied cases suggests a possible relationship between atherosclerosis and mortality in TAAD cases.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission lactate at ICU entry and the risk of postoperative delirium after cardiac surgery: a retrospective cohort study using the eICU-CRD database.","authors":"Qiankun Yang, ZhenGuo Luo, Jing Li, Gang Wu","doi":"10.1186/s12872-026-05915-5","DOIUrl":"https://doi.org/10.1186/s12872-026-05915-5","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium is a frequent complication after cardiac surgery. The predictive value of initial lactate at ICU admission for cardiac surgery-associated postoperative delirium (CS-POD) remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the eICU Collaborative Research Database, including adult patients admitted to the ICU after cardiac surgery. Multivariable logistic regression, restricted cubic spline analysis, ROC analysis, and mediation analysis were performed to assess the association between initial lactate and CS-POD and to explore whether disease severity scores (SOFA, APACHE IV) or clinical interventions statistically explained this relationship.</p><p><strong>Results: </strong>Among 358 patients, 104 (29.1%) developed CS-POD. Higher initial lactate at ICU admission was independently associated with increased risk of CS-POD after full adjustment (OR per 1 mmol/L increase: 1.37, 95% CI 1.11-1.69; P = 0.003). Restricted cubic spline analysis demonstrated a linear relationship between initial lactate and CS-POD risk (P for nonlinearity = 0.132). Adding initial lactate to the baseline prediction model improved discriminative performance, with the area under the ROC curve (AUC) increasing from 0.661 (95% CI, 0.598-0.723) to 0.717 (95% CI, 0.660-0.775) (DeLong test P = 0.012). The optimal lactate cutoff for predicting CS-POD was 2.385 mmol/L. Mediation analysis indicated that part of the association between initial lactate and CS-POD was statistically explained by SOFA (proportion statistically explained: 17%, P = 0.002) and APACHE IV (proportion statistically explained: 7.7%, P = 0.034), whereas clinical interventions (IABP, RRT, opioid use) did not show significant mediation. Higher initial lactate levels were also associated with increased risks of acute kidney injury (OR 1.27, 95% CI 1.00-1.61) and in-hospital mortality (OR 2.88, 95% CI 1.52-5.46).</p><p><strong>Conclusions: </strong>Higher initial lactate at ICU admission is associated with an increased risk of CS-POD and adverse postoperative outcomes. However, its predictive value is modest and should be interpreted cautiously as part of a broader clinical assessment rather than as an independent decision-making tool.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of short-duration head-up tilt test for unexplained syncope: a non-inferiority study.","authors":"Saijia Yang, Yuen Liang, Zhuoshan Huang, Lin Wu, Ruimin Dong, Kemei Liu, Shan Cao, Ling Jiang, Xujing Xie","doi":"10.1186/s12872-026-05846-1","DOIUrl":"https://doi.org/10.1186/s12872-026-05846-1","url":null,"abstract":"<p><strong>Background: </strong>The traditional head-up tilt test (HUTT) is time-consuming, imposing a noticeable burden on patients and on high-throughput syncope clinics. A 20-minute \"Fast Italian Protocol,\" introduced in 2023, promises to streamline the procedure, yet its diagnostic reliability-particularly the optimal length of the sublingual nitroglycerin head-up tilt test (SNHUT) segment-remains unclear.</p><p><strong>Methods: </strong>Between 2019 and 2025 we assessed 1,218 consecutive patients with unexplained syncope. Individuals were allocated non-randomly to a short protocol (10-minute baseline head-up tilt test (BHUT) + 20-minute SNHUT; n = 393) or the conventional protocol (20-minute BHUT + 20-minute SNHUT; n = 825). A one-sided non-inferiority analysis (α = 0.025; margin = - 10%) provided 90.7% statistical power.</p><p><strong>Results: </strong>Overall positivity did not differ between the short and conventional protocols (53.4% vs. 57.3%, p = 0.20), nor did the distribution of vasovagal reaction types (all p > 0.05). In the abbreviated arm, 86.4% of positive responses emerged within the first 10 min of tilt or nitroglycerin exposure, and 98.9% appeared within 15 min-proportions virtually identical to those observed with the conventional protocol (88.9% and 98.9%, respectively; p = 0.49).</p><p><strong>Conclusion: </strong>A 10-minute BHUT followed by a 20-minute SNHUT is diagnostically non-inferior to the standard 40-minute test. Furthermore, curtailing the SNHUT phase to 15 min retains 98.9% of positive findings while trimming total test time by 37.5%. This streamlined approach could ease patient burden and significantly boost throughput in high-volume syncope centers.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between vascular adhesion protein-1 and major adverse cardiovascular events in heart failure patients: a retrospective cohort analysis.","authors":"You Zhang, Chi Geng, Feng Li, Mengchao Jin, Siliang Peng, Zhiyuan Zhang, Xiaosong Gu, Jing Li, Hui Li","doi":"10.1186/s12872-026-05935-1","DOIUrl":"https://doi.org/10.1186/s12872-026-05935-1","url":null,"abstract":"<p><strong>Background: </strong>Vascular adhesion protein-1 (VAP-1), a multifunctional inflammatory mediator, has been implicated in cardiovascular pathology. Current evidence regarding its prognostic relevance in heart failure (HF) is incomplete. This investigation was designed to evaluate circulating VAP-1 as a biomarker for its association with HF progression susceptibility and its clinical prognostic value for adverse cardiovascular events.</p><p><strong>Methods: </strong>This retrospective observational cohort study included 356 individuals receiving treatment at Soochow University Hospital from May 2020 to September 2022, among whom 165 were diagnosed with heart failure. During the baseline evaluation, VAP-1 concentrations in blood serum were measured through ELISA testing. Major adverse cardiovascular events (MACE) were designated the principal study endpoints, with data collected from electronic health records and telephone follow-ups. Analytical methods incorporated multiple regression analysis, nonlinear modeling approaches, and Kaplan-Meier survival probability assessments. Additional analyses examined the association between heart failure progression and VAP-1 levels through multiple regression modeling, ROC curve assessment, and AUC calculations to establish VAP-1's diagnostic potential for heart failure identification.</p><p><strong>Results: </strong>When accounting for potential confounding factors, higher concentrations of VAP-1 showed a correlation with MACE in patients with HF (Q2 versus Q1: hazard ratios [HR] = 1.7, 95% confidence intervals [CI] = 0.71-4.12; Q3 versus Q1: HR = 2.85, 95% CI = 1.1-7.36). These results were further validated through survival probability assessments and non-linear regression modeling. Multiple regression analysis demonstrated that increased VAP-1 levels served as an independent risk factor for heart failure progression (P = 0.0271, HR = 1.0012, 95% CI = 1.0001-1.0022).</p><p><strong>Conclusions: </strong>The study demonstrates a meaningful relationship between heightened VAP-1 concentrations and both the development of heart failure and cardiovascular complications, indicating VAP-1's possible utility as a diagnostic marker for assessing heart failure risk and clinical outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early serum TIMP-2 as a biomarker for 90-day chronic kidney disease after percutaneous coronary intervention in ST-elevation myocardial infarction: a prospective cohort study.","authors":"Miras Mugazov, Eldar Saparov, Dmitriy Vassilyev, Alina Ogizbayeva, Natalya Vassilyeva, Dinara Omertayeva","doi":"10.1186/s12872-026-05904-8","DOIUrl":"https://doi.org/10.1186/s12872-026-05904-8","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced acute kidney injury (CI-AKI) remains a concern in patients with ST-elevation myocardial infarction (STEMI) undergoing emergent percutaneous coronary intervention (PCI), but creatinine-based CI-AKI definitions incompletely capture longer-term renal trajectories. Early tubular stress biomarkers such as tissue inhibitor of metalloproteinases-2 (TIMP-2) may provide incremental risk information beyond conventional functional markers.</p><p><strong>Methods: </strong>In this prospective single-centre cohort, we enrolled 88 consecutive STEMI patients undergoing urgent coronary angiography with or without PCI. Routine laboratory parameters were obtained at admission and 48 h. Serum TIMP-2 was measured 2 h after the procedure using a standardized sandwich ELISA. Early CI-AKI was defined by conventional creatinine-based criteria within 48 h, whereas 90-day chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² or persistent creatinine elevation at 90 days. We evaluated paired changes, between-group differences by 90-day CKD status, correlations, multivariable linear and logistic regression, and receiver operating characteristic (ROC) discrimination.</p><p><strong>Results: </strong>Early CI-AKI occurred in 6/88 patients (6.8%), whereas 90-day CKD was diagnosed in 15/88 (17%), indicating substantial delayed renal dysfunction beyond the 48-h window. The median 2-h serum TIMP-2 concentration was 1.20 ± 0.38 ng/mL. TIMP-2 showed modest correlations with creatinine and urea and remained independently associated with higher 90-day creatinine in multivariable linear regression (B = + 12.0 µmol/L per 1-ng/mL increase; p = 0.016) after adjustment for baseline creatinine and clinical covariates. In parsimonious logistic models, TIMP-2 demonstrated a borderline association with 90-day CKD (odds ratio ≈ 6.38; p = 0.056), while older age was a significant predictor. Standalone ROC discrimination for 90-day CKD was limited (AUC 0.528; 95% confidence interval 0.39-0.65; p = 0.668).</p><p><strong>Conclusions: </strong>In STEMI patients undergoing emergent angiography/PCI, 90-day CKD was considerably more frequent than early creatinine-defined CI-AKI, underscoring the need for extended renal follow-up. A single 2-hour serum TIMP-2 measurement reflects early tubular stress and independently associates with 90-day creatinine, but offers only modest standalone discrimination for 90-day CKD. TIMP-2 is therefore more likely to have a role within multivariable or biomarker panel-based risk stratification pathways rather than as an isolated classifier.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and electrical outcomes of conduction system pacing versus right ventricular pacing in atrioventricular block: a systematic review and meta-analysis.","authors":"Faizan Ahmed, Ayesha Zulfiqar, Ramsha Ali, Hafsa Arshad Azam Raja, Omama Ayatullah, Omar Kamel, Arsalan Ahmed, Haris Bin Tahir, Faseeh Haider, Muhammad Faiq Akram, Maryam Abbas Malik, Rubiya Ali, Sana Altaf, Haider Hussain Shah, Madeeha Shafqat, Daniel Aziz, Fawaz Alenezi, Eran S Zacks","doi":"10.1186/s12872-026-05930-6","DOIUrl":"https://doi.org/10.1186/s12872-026-05930-6","url":null,"abstract":"<p><strong>Introduction: </strong>Right ventricular pacing (RVP) is the conventional treatment for atrioventricular (AV) block, but may cause ventricular dyssynchrony and adverse remodeling. Conduction system pacing (CSP) has emerged as a physiologic alternative. This meta-analysis compared the efficacy, safety, echocardiographic, and electrical outcomes of CSP versus RVP in patients with AV block.</p><p><strong>Methods: </strong>From 2,688 records identified in PubMed, Cochrane, Embase, and ScienceDirect, 19 studies were included. Pooled efficacy, safety, echocardiographic, and procedural outcomes were analyzed using a random-effects model in R (v4.5.1), with meta-regression assessing follow-up effects; p < 0.05 was considered significant.</p><p><strong>Results: </strong>Nineteen studies comprising 5,390 patients (2,182 CSP; 3,208 RVP) were analyzed. Compared with RVP, CSP was associated with a reduction in all-cause mortality (RR 0.50, p < 0.0001), heart failure hospitalization (RR 0.39, p < 0.0001), pacing-induced cardiomyopathy (RR 0.36, p = 0.039), and the primary composite outcome (RR 0.44, p < 0.0001). Cardiovascular death, cardiac resynchronization therapy upgrade, and biventricular pacing upgrade did not differ significantly between groups. CSP was associated with improved left ventricular ejection fraction (MD +2.60%, p < 0.0001) and reduced left ventricular end-diastolic diameter (MD -1.54 mm, p < 0.0001) compared with RVP. Shorter paced QRS duration at implantation and follow-up was observed with CSP compared with RVP, indicating superior ventricular synchrony, although procedural and fluoroscopy times were longer. Meta-regression indicated that LVEF improvement decreased with longer follow-up, while LVEDD reduction remained consistent.</p><p><strong>Conclusion: </strong>CSP was associated with lower all-cause mortality, HF hospitalization, and pacing-induced cardiomyopathy, while improving ventricular function without additional device-related complications compared with RVP; however, these findings should be interpreted in the context of predominantly observational data.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}